# MARIEKE HEATWOLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538830237
- **Authorized official:** MRS. SANDRA K ELSIK (BUSINESS MANAGER)
- **Authorized official phone:** (907) 677-2990

## Contact information

- **Practice address:** 4101 ARCTIC BLVD STE 104, ANCHORAGE, AK 99503-5702
- **Practice address phone:** (907) 677-5910
- **Practice address fax:** (907) 600-7711
- **Mailing address:** 205 E. DIMOND BLVD, PMB553, ANCHORAGE, AK 99515
- **Mailing address phone:** (907) 677-5910
- **Mailing address fax:** (907) 600-7711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/22/2021
- **Last updated:** 03/18/2022